- NHS hospital
Northwick Park Hospital
Assessment report published 26 November 2025
Contents
Ratings - Urgent and emergency services
Our view of the service
We carried out an unannounced assessment of Northwick Park Hospital on 15 and 16 July 2025 in line with our assessment priorities. We assessed the following assessment service group.
Urgent and emergency care
Overall, the service was rated as Requires Improvement.
The emergency department (ED) had previously been inspected in November 2019. At this inspection the urgent treatment centre (UTC) was operated by a different provider. This was the first inspection of the service that included both the emergency department and UTC as a service provided by this trust. At our last inspection the emergency department was rated as requires improvement.
The department had different areas where patients were treated including, urgent treatment centre, majors, minors, resuscitation, rapid assessment unit, and paediatric emergency department. The department was open 24 hours a day 7 days a week to both walk in patients and those arriving by ambulance.
People could not always access care, support and treatment when they needed it with some patients waiting over 12 hours in the department.
Some patients were seen and assessed in temporary escalation areas where there was no privacy, and patients did not have access to call bells should they need assistance and staff were not always visible in the areas we visited.
The service didn’t always work well with people and healthcare partners to establish and maintain safe systems of care. This means we looked for evidence that people were protected from abuse and avoidable harm.
The service did not always assess or manage the risk of infection. Staff did not always wash their hands between patients.
Not all staff had completed safeguarding training, and several staff groups fell below the trust target completion rate of 90%.
Children were not streamed by a paediatric nurse when they arrived in the department, leading to some patients being streamed differently with similar injuries, placing them at risk of not receiving timely treatment.
The service had a shared vision, strategy, and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion and engagement. However, not all staff were aware of the vision, and it was unclear if this had been developed in collaboration with staff.
The service always treated people with kindness, empathy and compassion, however, in some areas their privacy and dignity was not always respected. Staff treated colleagues from other organisations with kindness and respect.
The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.
The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.
The service fostered a positive culture where people felt they could speak up and their voice would be heard.
The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.
People's experience of this service
People, their families, and carers were positive about their interactions with staff and the treatment they received. All people we spoke with reported that staff were welcoming and friendly, and that they were treated with compassion and kindness. Patients felt listened to and knew what the plan for their care was. The friends and families test showed that 98% of people had a positive experience in the department. However, there was a low response rate to this survey. Leaders told us the low response rate was due to issues in delivery of the survey. A new system has been implemented with automated messaging after each patient visit.
Patients told us they had been waiting in the department for a long time and did not know how long they may have to wait. Wait times were not displayed in the department.
The waiting area was noisy and there were not enough chairs for patients to sit on when the department was busy, meaning some patients sat on the floor or stood while they waited to be seen, leaving some people uncomfortable.
Some patients in the temporary escalation spaces (TES) told us they had not been offered food or drink while in the department, although it was not clear how long they had been waiting. The department provided food and drink 5 times a day at mealtimes including patients in the TES area.